Maternal mental health conditions are among the most prevalent complications during pregnancy and the postpartum period. There is also a significant economic burden associated with maternal mental health, costing $14 billion annually.
However, there are efforts to improve care for mothers struggling with maternal mental health challenges, including the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms. It helps providers address mental health issues of pregnant and postpartum patients. The program was discussed last week during a panel at the Behavioral Health Tech conference in Phoenix, in which experts shared how they successfully expanded the program across the country.
MCPAP for Moms was founded in 2014 by Nancy Byatt, a tenured professor at UMass Chan Medical School. On the panel, Byatt shared that she knows first hand the need for better maternal mental health support.
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“When my mom was born, my grandmother was very depressed, likely due to bipolar disorder,” she said. “Long story short, they went to their family physician, who told them that they should put an ad in the paper, and they found someone to take my mom. So they did that, and my mom was sent to go live with a family she never met for six months during her first year of life at the recommendation of the family physician, and they never had any contact with her biological family during that time.
“When my mom went back to her biological family after six months, my grandmother had never recovered,” Byatt continued. “From what I could tell, my grandmother was profoundly depressed, alternating with what we see with bipolar disorder throughout my mom’s upbringing. I saw my mom struggling with this. This impacted my mental health and also my children’s mental health.”
Because of this experience, Byatt went on to become a perinatal psychiatrist. Her patients often shared that they didn’t realize they were depressed until much later. Additionally, many had seen multiple healthcare professionals who never asked about their mental health or discussed depression with them.
“It was a missed opportunity to talk about this,” Byatt said. “The individuals, of course, didn’t know it had an impact on their kids, on their babies. As a psychiatrist, I thought, ‘Well, there’s this relationship where we have healthcare professionals seeing pregnant and postpartum individuals, they don’t know what to do.’ And we did focus groups, and this is what we heard. The perinatal professionals told us, ‘We don’t know what to do. We want to address this. We have no idea how.’ And the individuals with lived experience also told us they don’t know what to do.”
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That’s why Byatt went on to build MCPAP for Moms. It expands on the Massachusetts Child Psychiatry Access Program, which was created in 2004 and supports primary care providers in identifying and managing patients’ mental health challenges.
According to Byatt, MCPAP for Moms has three core components. It provides training for obstetricians on how to talk about maternal mental health, screen for it and address it. For those who screen positive for maternal mental health conditions, MCPAP for Moms can offer consultation. Lastly, the program gives resources and referrals to help patients navigate the healthcare system. In total, the program costs $14 per woman per year, Byatt added.
It has now achieved scale, with over 30 of these programs across the country. This is due in part to Jamie Zahlaway Belsito, founder and director of policy at the Maternal Mental Health Leadership Alliance. Zahlaway Belsito, who is from Boston and also spoke on the panel, helped the program get funding to scale because of her personal experience with maternal mental health challenges. During post pregnancy, she experienced compulsive thoughts and suicidal ideation. She added that not one provider spoke to her about these issues.
“I’m White-presenting, I speak English, I speak Bostonian, I am married, I have private insurance, it was a wanted pregnancy, I have a home and I could not find any support. … If people that look like me, that speak English like me can’t find that support, what does that mean for everybody else? We saw an evidence-based model that was far superior than the World Series when the Red Sox finally beat the Yankees. Why can’t we replicate something that costs $14 a year, that’s going to save lives?” Zahlaway Belsito said.
Another panelist — Malekeh Amini, CEO and founder of mental health tech company Trayt Health — discussed the role technology can play in scaling maternal mental health support. The company has maternal mental health programs that are modeled after Byatt’s program.
“As a healthcare system, we’re not structured to collaborate,” she said. “Our systems are institutional. They’re not speaking to each other. … One of the components of technology that I think is very important is the ability to streamline those workflows, to sit on top of those institutions.”
Editor’s note: The conference covered the reporter’s accommodations.
Photo: Arsenii Palivoda, Getty Images